This chapter investigates how creative changes at a community health center (CHC) in response to the COVID-19 pandemic affected community health, specific patient groups, and the workforce. We interviewed and conducted multidisciplinary analysis of 42 staff members, collaborating medical and nursing students, leaders of community organizations, and health department officials. From the outset of the pandemic, the CHC cared for its patients and broadened its community impact through creativity and pragmatism, leveraging pre-existing investment in developing a shared vision and relationships among the CHC staff, patients, and community partners. A quality improvement focus, showing respect for both staff and patients, and evolving partnerships with communities and student workers fostered macro- and micro-innovations that cultivated communication and reduced access barriers for addressing complex care in under-resourced populations. Innovations in response to the pandemic included telemedicine, online appointment scheduling, vaccine clinics, drive-up INR checks, and COVID-19 testing. The center’s pandemic response developed a population health team and a work culture embodying the grassroots nature of the CHC’s origin while functioning in a corporate organizational structure. We conclude that previous and ongoing investment in relationships and an improvement focus play vital roles in primary care CHCs’ ability to meet the needs of vulnerable populations during a crisis.